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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> NOTICE OF DEED RESTRICTIONS:The undersigned understands that this permit may be subject to"dead"restrictions'which may be more restrictive <br /> than County regulations.The undersigned assumes responsibility for compliance with any applicable deed restrictions. <br /> UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES:If the owner has hired a contractor or contractors to undertake work,they <br /> may be required to be licensed in accordance with state and local regulations.If the contractor is not licensed as required by law,both the owner and <br /> contractor may be cited for a misdemeanor violation under state law.If the owner or Intended contractor are uncertain as to what licensing requirements <br /> may apply for the intended work,they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847-8009. <br /> Furthermore,if the owner has hired a contractor or contractors,he Is advised to have the contractor(s)sign portions of the'contractor Block'of this <br /> application for which they will be responsible.If you,as the owner sign as the contractor,that may be an Indication that he Is not properly licensed and is <br /> not entitled to permitting privileges in Pasco County. <br /> TRANSPORTATION IMPACTIUTILITIES IMPACT AND RESOURCE RECOVERY FEES:The undersigned understands <br /> that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings,change of use In existing buildings,or <br /> expansion of existing buildings,as specified in Pasco County Ordinance number 89-07 and 90-07,as emended.The undersigned also understands,that <br /> such fees,as may be due,will be Identified at the time of permitting.It is further understood that Transportation Impact Fees and Resource Recovery <br /> Fees must be paid prior to receiving a'certificate of occupancy'or final power release.If the project does not Involve a certificate of occupancy or final <br /> power release,the fees must be paid prior to permit Issuance.Furthermore,if Pasco County Water/Sewer Impact fees are due,they must be paid prior <br /> to permit issuance in accordance with applicable Pasco County ordinances. <br /> CONSTRUCTION LIEN LAW(Chapter 713,Florida Statutes,as amended):If valuation of work Is$2,500.00 or more,I certify that 1,the applicant, <br /> have been provided with a copy of the"Florida Construction Lien Law—Homeowner's Protection Guide"prepared by the Florida Department of <br /> Agriculture and Consumer Affairs.If the applicant is someone other than the"owner',I certify that I have obtained a copy of the above described <br /> document and promise in good faith to deliver It to the'owner"prior to commencement. <br /> CONTRACTOR'S/OWNER'S AFFIDAVIT:I certify that all the Information in this application is accurate and that all work will be done in compliance with <br /> all applicable laws regulating construction,zoning and land development.Application Is hereby made to obtain a permit to do work and Installation as <br /> Indicated.I certify that no work or installation has commenced prior to Issuance of a permit and that all work will be performed to meet standards of all <br /> laws regulating construction,County and City codes,zoning regulations,and land development regulations In the jurisdiction.I also certify that I <br /> understand that the regulations of other government agencies may apply to the intended work,and that it is my responsibility to identify what actions I <br /> must take to be In compliance.Such agencies include but are not limited to: <br /> Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive <br /> Lands,Water/Wastewater Treatment. <br /> - Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering <br /> Watercourses. <br /> - Army Corps of Engineers-Seawalls,Docks,Navigable Waterways. <br /> - Department of Health & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment, <br /> Septic Tanks. <br /> US Environmental Protection Agency-Asbestos abatement. <br /> Federal Aviation Authority-Runways. <br /> I understand that the following restrictions apply to the use of fill: <br /> - Use of fill is not allowed in Flood Zone"V"unless expressly permitted. <br /> - If the.fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a <br /> .compensating volume"will be submitted at time of permitting which is prepared by a professional engineer <br /> licensed by the State of Florida. <br /> - If the fill material is to be used in Flood Zone "A" in connection with a-permitted building using stem wall <br /> construction,I certify that fill.will be used only to.fill the area-within the stem wail.. <br /> If fill material is to be used In any area, I certify that use of such fill will not adversely affect adjacent <br /> properties. If use of fill is found to adversely affect adjacent properties,the owner may be cited for violating <br /> the conditions of the building permit Issued under the attached permit application,for lots less than one(1) <br /> acre which are elevated by fill,an engineered drainage plan is required. <br /> If I am the AGENT FOR THE OWNER,I promise in good faith to Inform the owner of the permitting conditions set forth in this affidavit prior to <br /> commencing construction.I understand that a separate permit may be required for electrical work,plumbing,signs,wells,pools,air conditioning,gas,or <br /> other Installations not specifically Included in the application.A permit issued shall be construed to be a license to proceed with the work and not as <br /> authority to violate,cancel,alter,or set aside any provisions of the technical codes,nor shall Issuance of a permit prevent the Building Official from <br /> thereafter requiring a correction of errors in plans,construction or violations of any codes.Every permit issued shall become invalid unless the work <br /> authorized by such permit Is commenced within six months of permit Issuance,or,if work authorized by the permit is suspended or abandoned for a <br /> period of six(6)months after the time the work Is commenced.An extension may be requested,In writing,from the Building Official for a period not to <br /> exceed ninety(90)days and will demonstrate justifiable cause for the extension.If work ceases for ninety(90)consecutive days,the job Is considered <br /> abandoned. <br /> WARNING TO OWNER: YOU FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR <br /> PAYING TWICE FORM <br /> OR OV MENTS TO YOUR PROPERTY.IF YOU INTEND TO OBTAIN FINANCING,CONSULT <br /> WITH YQUIR LEN13ER 0 �Nl EFORE RECORDING YOUR NOTICE OF COMMENCIEMENT, <br /> FLORIDA JURAT(F.S.117.0 <br /> OWNER OR AGENT CONTRACTORS - ---- �—� <br /> Sub cri ed and swo to or ed tore m this Subscribed and sworn to(or affirmed)before me this <br /> 12 W b., ka . ,by ---- _ <br /> I ar y mown to ffilte has/have produced Who is/are perso`naily known-to me'or has/hava produced <br /> asidentifiocation. asldentification. <br /> Notary Public Notary Public <br /> Commission No. Commission No. <br /> Name Name of Notary typed,printed or stamped <br /> �-1��'• WILLIAM HENRY BISHO]22a3. <br /> ?°• �� Notary Public•State of F <br /> ��A�' Commission 8 GG 310 <br /> My Comm.Expires Mar 11Bonded through National Nota <br />